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Organization

MS VAISMAN MEDICAL SERVICES A PROFESSIONAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARK VAISMAN MD (PRESIDENT CEO)
(818) 506-6937
Entity
Organization

Contact information

Practice address
11724 VENTURA BLVD, SUITE A, STUDIO CITY, CA 91604
(818) 506-6937
(818) 506-2594
Mailing address
11724 VENTURA BLVD, SUITE A, STUDIO CITY, CA 91604
(818) 506-6937
(818) 506-2594

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A38899
CA
2085N0700X
Neuroradiology Physician
2085R0202X
Diagnostic Radiology Physician
2085R0204X
Vascular & Interventional Radiology Physician
2085U0001X
Diagnostic Ultrasound Physician
208600000X
Surgery Physician
208D00000X
General Practice Physician
Primary
A38899
CA
225100000X
Physical Therapist
2278P1004X
Pulmonary Diagnostics Certified Respiratory Therapist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00A388990
BLUE SHIELD
CA
05
00A388990
CA
01
047692
HEALTH NET
CA
01
124100111
PACIFICARE REGAL HMO
CA
01
146780057
PACIFICARE NIPA HMO
CA
01
146970061
PACIFICARE ST VINCENT
CA
01
19190
CARE 1ST HEALTH PLAN NOBL
CA
01
206140013
PACIFICARE PREMIER HMO
CA
01
24013
UHP
CA
01
2840525
AETNA HMO
CA
01
3709552
CIGNA PPO
CA
01
3709552008
CIGNA PREMIER HMO
CA
01
4341338
AETNA PPO
CA
01
DK033
UNIVERSAL CARE
CA
Enumeration date
09/26/2006
Last updated
09/22/2010
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